Quality Of Care

Cigna, VA Combat Opioid Abuse in Veterans with Chronic Pain

by Jessica Kent

The Department of Veterans Affairs (VA) has partnered with Cigna to improve patient safety and care quality for chronic pain patients at risk for opioid abuse. The partnership aims to educate...

Humana Launches Value-Based Care Oncology Program for MA Members

by Jessica Kent

Humana is launching a new value-based care oncology program designed to deliver integrated cancer care for Humana Medicare Advantage and commercial members. The national Oncology Model of Care (OMOC)...

CMS Approves Medicaid 1115 Waiver in Maryland

by Jessica Kent

CMS has approved Maryland’s section 1115 waiver application for a demonstration to expand access to diabetes care, substance abuse services, and other healthcare services for Medicaid...

NCQA Seeks Comment on Proposed Updates to HEDIS Quality Measures

by Jessica Kent

The National Committee for Quality Assurance (NCQA) is seeking comments from health plans, purchasers, consumers, and other stakeholders on proposed updates to the Healthcare Effectiveness Data and...

Humana, Aledade Bring Value-Based Care to Medicare Advantage Members

by Jessica Kent

Humana and Aledade have announced a value-based care agreement that will increase access to value-based care for Medicare Advantage members. The partnership will enable physicians in Aledade’s...

Atrius Health, Blue Cross to Create Alternative Payment Model

by Jessica Kent

Atrius Health and Blue Cross Blue Shield of Massachusetts have partnered to launch an advanced alternative payment model that will deliver a higher quality, more affordable healthcare experience. In...

Patient-Centered Methods Help Health Plans Boost Cancer Care

by Jessica Kent

Employers and payers should ensure their health plans use patient-centered methods and provider performance measurement strategies to reduce costs and improve cancer care, a report from the National...

Steward Health Care Joins Mission to Expand Generic Drug Access

by Jessica Kent

Steward Health Care has become a founding member of Civica Rx, a collaborative, non-profit drug company with the mission to reduce drug costs and increase the supply of life-saving generic...

Patient-Centered Medical Home Model Saved BCBS of MI $626M

by Thomas Beaton

BlueCross BlueShield of Michigan has reduced expected spending by $626 million over a nine-year period through a patient-centered medical home (PCMH) model that emphasizes personalized care. The payer...

How Payers Can Succeed Under Updated 2019 HEDIS Measures

by Thomas Beaton

The Healthcare Effectiveness Data and Information Set (HEDIS) provides 90 percent of America’s health plans with the ability to directly compare performance across the national stage....

Medicaid Coverage Creates Significant Healthcare Opportunities

by Thomas Beaton

Medicaid coverage led to significant healthcare opportunities that rivaled commercial health insurance care quality, according to a new study from AHIP. Nearly 74 million adults and children who...

UnitedHealthcare Finds Value-Based Care Closed 50M Gaps in Care

by Thomas Beaton

Value-based care helped close 50 million gaps in care between 2013 and 2017 while reducing care costs, lowering ED utilization, and increasing provider care quality, according to a new report from...

UnitedHealthcare Assists Phoenix Children’s Value-Based Care Goals

by Thomas Beaton

UnitedHealthcare and Phoenix Children’s Care Network (PCCN) have launched an accountable care program aimed at a lowering costs and improving care quality. UnitedHealthcare will share data with...

How Payers Address the Four Domains of Chronic Disease Prevention

by Thomas Beaton

Payers have an opportunity to improve chronic disease prevention and limit chronic disease spending by addressing the both medical and non-medical factors of chronic conditions. Payers can determine...

Health Plan Partnership Aims to Boost Care for Native Americans

by Thomas Beaton

A merger between Tribal First (a subsidiary of Alliant Specialty Insurance Services) and American Indian Health Services (AIHS) will combine two national leaders in providing quality care to Native...

Top Commercial Payers Offering Medigap, MA, and Medicaid Plans

by Thomas Beaton

The top payers with the highest enrollment numbers for Medigap, Medicaid, and Medicare Advantage (MA) are a unique mix of some of the largest commercial payers as well as smaller to mid-size insurers,...

Socioeconomic Data Improves Public Health, Payer Programs

by Thomas Beaton

CMS programs recognize that the social determinants of health (SDOH) play a large role in the health of their beneficiaries and, when neglected, can create negative health implications for...

Healthcare Leaders Air Concerns about NQF SDS Trial Period

by Thomas Beaton

A group of healthcare organizations wrote a letter to the National Quality Forum (NQF) calling for a one-year extension of the Sociodemographic (SDS) Trial Period that evaluates how social factors...

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